(Fremont County Public Health Nurse Jamie Cardine stood next to a “Pack & Play” crib now available for new mothers without a safe place for their baby to sleep. Ernie Over photo.)

(Lander, Wyo.) – The MAPPing a Healthier Fremont County Coalition has released its 2012 Community Health Assessment and in it identified priority areas to focus efforts for improving the overall health of Fremont County residents.

“Mobilizing of Action through Planning and Partnerships (MAPP) is a community-driven strategic planning process for improving community health,” states the report. The primary driver for the assessment stems from the fact that Fremont County has been ranked as the least healthy county in the state four years in a row, Fremont County Public Health Nurse Jamie Cardine said in an interview.

Cardine, in presenting the report during an interview, emphasized the community effort that went into the assessment. More than 33 individuals representing various organizations and communities participated in the coalition.

The MAPPing project began in April 2011 and was just completed early last week.

According to the report, the priorities are as follows:

“Priority Issue #1: Fremont County has a very high death rate from unnatural causes. Most unnatural deaths in Fremont County involved alcohol or drugs.”

“Priority Issue #2: Fremont County has significant poverty and disparity of income. Fremont County’s ability to link citizens to services was average which may lead to health disparities for low income residents.”

Cardine said the process now is to use this information to begin addressing the problems. “We want to actually implement some things that help the community,” she said. Local agencies are encouraged to use the report’s data to seek grants. (The complete report is available at this link.)

Local legislators, and the state’s U.S. Legislators, have been invited to a breakfast in June to discuss the data. Some.

Some projects have already begun to be implement. One is a Safe Sleep Grant that provides resources for young parents (read a story about that project here). Another project in the works is Life R U Ready, which will work with local middle schools to provide an interactive experience showing the students possible outcomes of poor choices.

In order to get to the priorities, the Coalition collected, compiled and evaluated data about Fremont County’s residents.

The median age in the state is 36.8. In Riverton, the median age is 35. In Arapahoe it is 24.8, and 25.1 in Ethete. In Lander the median age is 40.3. Jeffrey City has the oldest median age at 56. Using this data, Cardine said she would be able to focus parenting or family planning efforts (more toward the younger populations versus the older populations).

Median income is $47,179 in Lander (the highest in the county) to $16,000 in Arapahoe (the lowest), the report shows. The percentage of people below the poverty level is just under 20 percent for those ages 64 and under. The statewide percentage is about 13 percent.

“We are not underserved as far as health services go,” Cardine said, noting that the county ranks fourth best in the state. This compared with being named the least healthy county, she says, indicates problems access to healthcare. That is the focus of priority number 2 listed above.

Drinking in Fremont County ranks, percentage-wise, similarly with the state as a whole. In 2005-2009, 13.5 percent of people in the county reported binge drinking (5 or more drinks in one sitting) at least once in the prior month. That compares with 14.6 percent statewide. Tobacco use is a little higher in the county at 23.6 percent compared to the state’s 19.5 percent.

“In 2011, Drugs and Alcohol were involved in 71% of homicides, 35% of suicides, and 41% of accidental deaths,” the report states. Fremont county is also reportedly the worst in the state regarding alcohol-related motor vehicle fatalities. Between 2005 and 2009, the county’s rate for such deaths was 33 in 100,000 people. Statewide the rate was 12 per 100,000.

In the county, the report names co-sleeping as the top cause of infant deaths in the county at 10 from 1999-2011. Second was sepsis at 9 deaths. Neglect or abuse accounted for 6 deaths. In 2010, there were 50 substantiated cases of abuse or neglect in children under 20 years of age.

Cancer, while generally viewed as significant problem in the county, is lower in some specific cancers than the state average, the report shows. The rates of breast and lung cancer are below the state average. Cervical and colorectal cancer are slightly higher.

The rates of chronic diseases for both white and Native American individuals is higher than the state average. Chronic liver disease among the Native American population is 119.03 per 100,000 people in 2005-2009. For white individuals that rate is 14.55. Statewide it is 11.67.

Fremont County also has the second-highest rate of chlamydia in the state, with 506 out of 100,000 people affected. Laramie County was the highest at 560.

In a survey with 1106 respondents, cancer, child abuse/neglect and diabetes were believed to be the biggest health problems in the county. Respondents name alcohol abuse as the worst risky behavior locally. Drug use and being overweight were the second highest.

The majority of respondents (54 percent) believe their community is “somewhat unhealthy.” However, 53 percent believe their personal health was “healthy.”

Of the respondents, 57 percent were from Riverton, 17 percent from Lander, 9 percent from Wind River Indian Reservation communities, 9 percent from Dubois and 4 percent from Shoshoni. Fifty-four percent had a college degree or higher.